Provider Demographics
NPI:1104023282
Name:BITET, JANICE L (LCSW)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:L
Last Name:BITET
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6910 108TH ST
Mailing Address - Street 2:#3-O
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-3852
Mailing Address - Country:US
Mailing Address - Phone:212-726-3092
Mailing Address - Fax:718-262-4414
Practice Address - Street 1:85 5TH AVE
Practice Address - Street 2:SUITE 931
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3019
Practice Address - Country:US
Practice Address - Phone:212-726-3092
Practice Address - Fax:718-262-4414
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR037982-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP747307Medicare UPIN
NYN5M611Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER